WIND Airway clearance system-A Lifestyle-integrated airway clearance solution based on wearable acoustics tech

Year Submitted: 2020
Published Date: 31 December 2020

Tags: Applied/Translational Research, Quantitative Research, Care Continuum, Acute Care

About this Content

Aims

The aim of this study is to assess the usability and effectiveness of a wearable, hand-free device (WIND) in providing airway clearance for patients with bronchiectasis.

Background

Patients with bronchiectasis have excessive viscous sputum due to persistent inflammation in the damaged airways. Majority of patients have productive cough, shortness of breath, wheezing and recurrent chest infections. In addition to living with persistent symptoms, these patients experience lifelong clinical, economic and social consequences from recurrent hospitalizations, work days lost, and poor quality of life. Enhanced and consistent quality airway clearance will improve the management of this condition while reducing the risk of an acute exacerbation. WIND is a portable device generates oscillatory percussion in the airways via a nasal passage by using clinically established frequencies between 5 and 1200 hz. (McIlwaine et al., 2013; Svenningsen et al., 2015; App et al., 1998). This will loosen up sputum along the airways and facilitate sputum expectoration. In long term, the potential benefits are improvement in airway mucus clearance, reduction in chest infection, and enable maintenance of life activities (e.g., patient use WIND for airway clearance and work on computer simultaneously). WIND is a life-style integrative therapy for patients with stable bronchiectasis. We hypothesise that WIND will improve airway mucus clearance experience for bronchiectasis patients due to its independent and automated mode of action as compared to conventional chest physiotherapy which is care-giver dependent.

Methods

This is a prospective, pre-post, single-arm study. Patients will be identified and interviewed at TTSH respiratory out-patient clinic. Demographic details (age, gender, BMI, ethnicity), recent pulmonary function, sputum microbiology, smoking history, current medications, chest physiotherapy regimen, sputum colour score, breathless cough sputum (BCS) score, COPD assessment test (CAT) score, mMRC breathless score, bronchiectasis severity index (BSI), number of pulmonary exacerbations (past 12 months) and the date of the last episode of pulmonary exacerbation will be recorded. On days 1 and 2, subjects will perform routine standard chest physiotherapy for airway clearance. This will be the control window of the study. On days 3 and 4, subjects will receive the WIND therapy for airway clearance. This will be the treatment window of the study.

Results

The primary outcome measure is patient satisfaction with the treatment. Study participants will be asked to share feedback in the form of questionnaires at the end of each treatment window. The feedback will be on the usability, perceived effectiveness and ease of use (e.g. degree of freedom) during treatment. The secondary outcome measure of the study is the clinical effectiveness which includes patient feedback and total volume of sputum (ml) produced after each course of treatment.

Results show that WIND is not associated with any adverse events, significantly reduced CAT score (ie improved quality of life), majority feedback that WIND is comfortable to wear for Rx, easy to use, cleared sputum, allowed flexibility and freedom to move when using it.

Conclusion

For this pilot short term study, WIND is safe, user friendly and effective on airway clearance. The longer term safety of WIND and its superiority over conventional chest physiotherapy will need to be studied.

Lessons Learnt

WIND study required a lot of coordination between clinic, subjects and the study team. It also required detailed explanation to the subject as it is a novel therapy. Good time management, good team support and coordination are crucial for this type of complex study. Future study may be better to conduct at the clinical trial centre.

Keywords

Airway clearance, self-treatment, bronchiectasis

Innovators' Details

Connect with this contributor!

Lim Yick Hou Albert - Albert_ly_hou@ttsh.com.sg

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